Organization
DECEMBER ROSES, LLC
Active
Other names
Senior Helpers - Metro Portland North
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY NORMAN HARRIS JR. MHSA (OWNER/ADMINISTRATOR)
(503) 257-7787
Entity
Organization
Contact information
Practice address
12740 SE STARK ST, BUILDING F, PORTLAND, OR 97233-1539
(503) 257-7787
(888) 748-7787
Mailing address
12740 SE STARK ST, BUILDING F, PORTLAND, OR 97233-1539
(503) 257-7787
(888) 748-7787
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2265
OR
253Z00000X
In Home Supportive Care Agency
60269071
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-2265
OREGON HEALTH AUTHORITY PUBLIC HEALTH DIVISION
OR
01
—
60269071
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
10/07/2015
Last updated
10/07/2015
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